Caries in orphan children: prevalence and determinants-a systematic review and meta-analysis.

BACKGROUND: Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants. METHODS: The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature. RESULTS: The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth. CONCLUSION: Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched. TRIAL REGISTRATION: Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023.

"Challenges and concerns faced by parents of a group of Egyptian children with cleft lip/palate: a qualitative study".

BACKGROUND: Cleft lip and palate are the most common developmental anomalies that affect the mouth and related structures. They can both affect children physiologically, socially, and functionally and lead to psychological distress in their parents. The present study aims to understand the challenges parents of cleft lip and palate patients face in Egypt, elucidate how they cope with these challenges, and assess their concerns for the future. METHODS: For the present phenomenological qualitative exploration, the parents of cleft lip and palate patients attending the cleft care clinic were invited to participate in the study through face-to-face recruitment at the clinic. An interview guide about the research question was developed to include standardized open-ended questions providing a framework for structured discussions. The interviews were audio-recorded after obtaining written informed consent from participants then collected data were transcribed for data analysis. RESULTS: Of the 12 participants, there were nine mothers and three fathers. Their children's ages ranged from 1.5 years to 19 years and had different presentations of cleft lip and palate from unilateral cleft lip to complete bilateral cleft lip and palate. Feeding difficulty was one of the main challenges encountered by the parents. At the same time, fear of being subjected to bullying was the main concern for the future of their children. Six themes were noted that were continually reported: Health & Wellbeing; Parental emotions; Parental attitudes & behaviors; Financial aspects; Relationship aspects; and Career/Education. CONCLUSIONS: There were 4 factors that directly impacted the themes, namely: the type of cleft, gender of the child, gender role of the parent, and the age of the child impacted the parental concerns and the challenges faced under the influence of sociocultural beliefs and existing support systems.

Assessment of dental caries among a group of institutionalized orphan children compared to parented school children: case-control study.

BACKGROUND: It has been well documented that the absence of family support influences the general and oral health of children. Literature regarding the oral health status of institutionalized orphan children, who lost their families' support, especially in Egypt, remains vague. Therefore, the current study was carried out to assess dental caries among two groups of institutionalized orphan children, and compare their results with a group of parented school children in Giza, Egypt. METHODS: A total of 156 children were included in this study, residing in a non-governmental orphanage, a governmental orphanage, and parented children attending private primary school. Written informed consent was obtained before the start of the study from the legal guardians or the child's parent. The dental examination was carried out as recommended by the WHO. DMF and def indices were used to assess dental caries for primary and permanent teeth. Also, the unmet treatment needs index, care index, and significant caries index were calculated. RESULTS: The results revealed that mean values for DMF total score were 1.86 ± 2.96, 1.80 ± 2.54, and 0.7 5 ± 1.29 for, non-governmental, governmental orphanages, and school children respectively. While the mean def total scores were 1.69 ± 2.58, 0.41 ± 0.89, and 0.85 ± 1.79 for non-governmental, governmental orphanages, and school children, respectively. There was a high level of unmet treatment needs, especially among orphans. The significant caries index was 2.5, 4.29, and 2.17 for, non-governmental, governmental orphanages, and school children, respectively. CONCLUSIONS: Within the limitation of this case-control study, the institutionalized orphanage children had a high prevalence of dental caries and worse caries experience compared to parented school children. Effective oral health preventive strategies are required to improve the oral health status and oral health practices of those children. TRIAL REGISTRATION: The trial was registered on ClinicalTrial.gov (ID: NCT05652231).

Cone-beam computed tomography analysis of primary root canals transportation and dentin loss after instrumentation with two-pediatric rotary files.

BACKGROUND: This in vitro study aims to compare rotary files (Fanta and Zuanba) with manual K files according to the amount of dentin removed and canal transportation in primary mandibular second molars by CBCT images. METHODS: This experimental study was conducted on 60 extracted human second primary molars. That were divided into three groups according to root canal preparation group "I" instrumented with manual K-files, group "II" instrumented with rotary Fanta files, and group "III" instrumented with rotary Zuanba files. After root canal preparation, teeth were scanned before and after mechanical preparation with CBCT scanner. Then the amount of dentin removed was determined at three levels, including the coronal, middle and apical levels. Data were statically analysed using the Kruskal-Wallis test. RESULT: No statistically significant difference in the amount of dentin removed were noted between the manual and the rotary groups at the coronal and apical RC levels (P = 0.420) and (P = 0.819) respectively but significant difference was noted at the middle third (P = 0.043). Regarding RC transportation, no significant difference was noted among the three groups with the exception of the apical RC level (P = 0.043). CONCLUSION: Although no significant differences were noted between rotary and manual files, the rotary files showed better performance.

Picture Examination Communication System Versus Video Modelling in Improving Oral Hygiene of Children with Autism Spectrum Disorder: A Prospective Randomized Clinical Trial.

Purpose: The purpose of this study was to compare video modelling (VM) to a Picture Exchange Communication System (PECS) aimed at improving the oral hygiene of children with autism spectrum disorder (ASD). Methods: This prospectively stratified randomized controlled trial was conducted on 50 children with mild and moderate ASD. Children were assigned into two balanced groups. The control group was educated through PECS, and the intervention group was exposed to VM. Oral hygiene was assessed using the Oral Hygiene Index-simplified (OHI-s) on four occasions (at baseline and at three, six, and 12 months). Quantitative data were analyzed using Fisher's exact test and a t-test at a five percent significance level and 95 percent confidence interval (95% CI), respectively. Spearman's rank correlation coefficient (r) was used to correlate baseline characteristics in both groups to obtain average OHI-s scores. Results: The VM group showed a statistically significant reduction in average OHI-s scores compared to the PECS group over the follow-up period (P<0.001). At three, six, and 12 months, the OHI-s mean differences were 0.30 (95% CI equals 0.14 to 0.47), 0.58 (95% CI equals 0.39 to 0.77), and 0.57 (95% CI equals 0.30 to 0.84), respectively. For both groups, the severity of ASD was moderately associated with OHI-s scores at 12 months. Conclusion: Video modelling showed superior results in improving the oral hygiene of children with autism spectrum disorder compared to the Picture Exchange Communication System.

Clinical Evaluation of CAD/CAM Ceramic Endocrown Versus Prefabricated Zirconia Crown in the Restoration of Pulpotomized Primary Molars: A Two-Year Spilt-Mouth Randomized Controlled Trial.

OBJECTIVES: The current trial aimed to compare lithium disilicate (LS2) endocrowns' clinical performance, gingival health, and parental satisfaction to those of prefabricated zirconia crowns (ZCs) over a 24-month of follow-up. MATERIALS AND METHODS: This study designed as a spilt-mouth randomized controlled trial. A total of 88 pulpotomized mandibular second primary molars of 44 children were assigned into two equal groups. Forty-four molars were restored with prefabricated primary ZCs (control group) and the same number were restored with LS2 endocrown (intervention group). Clinical performance and gingival status were evaluated using a modified United States Public Health Service criterion, and plaque and gingival indices. Parental satisfaction was assessed using a 5-point Likert-scale questionnaire. STATISTICAL ANALYSIS: Paired data were analyzed using McNemar's test, a statistical test used on paired nominal data, and paired t-tests. The significance level was set to 5% at 95% confidence interval. RESULTS: Both restorations showed comparable gingival health status over the follow-ups. Marginal adaptation of the endocrowns and ZCs at the end of follow-up was 95.5 and 90.9%, respectively (p = 0.68). For marginal integrity and discoloration, both restorations showed similar results at the follow-ups. The overall parental satisfaction of both groups was statistically insignificant (p = 0.07). However, parents were more satisfied with the endocrown color over that of the ZC (p < 0.05). CONCLUSION: Endocrowns' clinical performance and gingival health were comparable to those of ZCs. For both restorations, parental satisfaction was nearly similar except for the color that showed an advantage in favor of the endocrowns.

Structural and Electrochemical Analysis of CIGS: Cr Crystalline Nanopowders and Thin Films Deposited onto ITO Substrates.

A new approach for the synthesis of nanopowders and thin films of CuInGaSe2 (CIGS) chalcopyrite material doped with different amounts of Cr is presented. The chalcopyrite material CuInxGa1 - xSe2 was doped using Cr to form a new doped chalcopyrite with the structure CuInxCryGa1 - x - ySe2, where x = 0.4 and y = 0.0, 0.1, 0.2, or 0.3. The electrical properties of CuInx CryGa1 - x - ySe2 are highly dependent on the Cr content and results show these materials as promising dopants for the fabrication thin film solar cells. The CIGS nano-precursor powder was initially synthesized via an autoclave method, and then converted into thin films over transparent substrates. Both crystalline precursor powders and thin films deposited onto ITO substrates following a spin-coating process were subsequently characterized using XRD, SEM, HR-TEM, UV-visible and electrochemical impedance spectroscopy (EIS). EIS measurement was performed to evaluate the dc-conductivity of these novel materials as conductive films to be applied in solar cells.

Premixed bioceramics versus mineral trioxide aggregate in furcal perforation repair of primary molars: in vitro and in vivo study.

OBJECTIVES: The current study was carried out to (1) evaluate premixed bioceramic (BC) and mineral trioxide aggregate (MTA) sealing properties in a laboratory and (2) compare the performance of these two materials in repairing an immediate iatrogenic furcal perforation of primary molars both clinically and radiographically. MATERIALS AND METHODS: In vitro sections including eighty mandibular second primary molars were sorted into 4 equal groups: (1) an intact furcation area group, (2) an artificial perforation group (unrepaired), (3) an artificial perforation group repaired with MTA, and (4) an artificial perforation group repaired with premixed BC. The dye extraction method was used to assess the sealing ability of the material. Clinically, the study was designed as an equivalent parallel randomized controlled trial. Seventy-six mandibular second primary molars with immediate furcal perforation were sealed with MTA and premixed BC. Teeth were evaluated clinically and radiographically at 3, 6, and 12 months. RESULTS: Although the difference was statistically insignificant (p = 0.058), the premixed BC group had better sealing ability than the MTA group [mean difference = 0.020; 95% CI (-0.001, 0.040)]. Clinically and radiographically, the two materials had an equivalent success rate in the first 3 months [ARR = 0.05; 95% CI (-0.07, 0.17)] but inequivalent success rates at 6 and 12 months with premixed BC performing better than MTA. CONCLUSIONS: The present findings confirm that premixed BC is a promising material that can be used to repair a furcal perforation of primary molars. Premixed BC has better sealing properties and better performance at the clinical and radiographic levels than MTA. CLINICAL RELEVANCE: (1) Accidental furcal perforation in primary molars is one of the worst problems that results in diminishing the lifetime expectancy of primary teeth if not properly treated. Though new BC repair materials have been introduced to enhance healing and tissue inductive properties, there is an obvious shortage in clinical trials covering this area. The present study is a premier study that assesses a recently introduced premixed BC material in the furcal perforation of primary teeth and compares its outcomes with those of the widely used MTA. TRIAL REGISTRATION: ClinicalTrials.gov PRS reference #NCT04137861.

Untreated dental caries prevalence and impact on the quality of life among 11 to14-year-old Egyptian schoolchildren: a cross-sectional study.

BACKGROUND: This study aimed to assess caries prevalence and experience among 11 to 14 years, school children, analyze demographic, socioeconomic, personal and professional dental care in relation to untreated carious lesions, and evaluates the effect of decayed teeth on early adolescents' oral health-related quality of life (OHRQoL). METHODS: A cross-sectional analytical investigation was conducted on 1020 preparatory schoolchildren selected on the basis of a multistage sampling technique. Caries status of the participants detected via recording their caries experience and untreated cavities using DMFT and DT indices. OHRQoL was determined using a validated Arabic CPQ11-14 short-form questionnaire. Statistical methods for descriptive analysis, chi-square test, Independent-Samples t test and one-way analysis of variance (ANOVA) were used. Multivariate Poisson regression analysis through a hierarchical approach was used to detect the influence of independent variables on DT scores. To declare the association between independent variables and QoL, a step-by-step, multivariate regression analysis was conducted. RESULTS: The average scores of DMFT and DT in this study were 2.97 ± 1.29 and 1.66 ± 1.24. Poisson regression analysis demonstrated that early adolescents whom their mothers with a lower level of education and of low socioeconomic status were 1.41 and 1.27 times respectively had higher DT scores when compared with their peers. Untreated cavities affected mainly by mother education, school type, family income, and regular dental appointments. Children with DMFT≤3) or DT = 0 recorded a statistically significant lower CPQ11-14 average score (p<0.01) and (p<0.0001) respectively. CONCLUSIONS: Untreated carious cavities and caries experience were associated with lower socioeconomic, maternal education andl ess frequent tooth brushing. Untreated carious cavities have a significant negative impact on schoolchildren's QoL.

Oral-cancer knowledge, practice, and attitude assessment of dentists in Upper Egypt: A cross-sectional study.

The aims of this study were to investigate the knowledge, attitude, and practice of dentists in Upper Egypt with regard to oral cancer (OC). Out of 1,200 licensed dental practitioners list, 424 dentists were randomly selected from three governorates in Upper Egypt (Minia, Assuit, and Sohag). The sample size was calculated using the equation considering the knowledge of dentists about OC, confidence level, and margins of error; then, an additional number of dentists were added to guard against nonresponse. Data were collected by face-to-face interview using 44 items divided into four sections; first part demonstrates sociodemographic. The second part concerned with the knowledge about OC clinical presentation and diagnosis (12 multiple-choice questions) as well as its risk factors (17 close-end questions). The third part consists of six questions focused on the practice of participants, and finally, the last part measures attitude of dentists. The chi-square test was used to compare between the two or more proportions. A correlation was used for describing the relationship or association between two mutually numerical dependent variables. p < 0.05 was considered to indicate significance. Rate of response was 94.3%. The overall knowledge level in the current study was 31.8%. The awareness about OC risk factors was high especially, smoking tobacco and alcohol consumption. Also, over 80% of dentists identified family history and human papillomavirus (HPV) as risk factors. Only 37.5% of participants performed regular screening of oral mucosa, and 26.5% reported lymph-node examination. Regarding attitude, only one quarter of dentists attended continuing educating programs about OC. A statistically significant relation (p < 0.0001) between knowledge level and most demographic variables was detected. There was a fair positive correlation (r = 0.47) between practice and knowledge scores. A predominant trouble among dentists in Upper Egypt was regarding OC knowledge and practice. Continues education and training programs are highly recommended.

Applicability of Demirjian's method for dental age estimation in a group of Egyptian children.

AIMS: The aims of this study were to evaluate the applicability of Demirjian's method for dental age assessment in a group of Egyptian children in Minia city and to develop an age predictive equation suitable for the studied group. SUBJECTS AND METHODS: In this retrospective, blind, cross-sectional study, 160 dental panoramic radiographs (DPTs) were selected from 420 DPTs from healthy children aged between three and 10 years old from the archived medical files of patients attending Minia University Dental Hospital (MUDH) and evaluated to estimate dental ages. RESULTS: Age was overestimated for almost all of the studied subjects with an accuracy range from 0.18 to 1.19 years for males and from 0.08 to 0.87 years for females, with the exception of two age subgroups (9-10-year-old males and 10-11-year-old females, for which the mean difference values were -0.06 and -0.008 years, respectively). A Logistic regression was used to generate a suggested formula for dental age estimation. CONCLUSIONS: Demirjian's method may be unsuitable for Egyptian children living in Minia city. Development of a predication equation and the introduction of adaptable conversion tables to transform the maturity score into a dental age for Egyptian children may be suitable alternatives. The validity of the newly developed prediction equation must be tested among all Egyptian children.

In Vitro Comparative Analysis of Fracture Resistance of Lithium Disilicate Endocrown and Prefabricated Zirconium Crown in Pulpotomized Primary Molars.

AIM: This study aimed to evaluate the effect of lithium disilicate endocrowns compared to prefabricated zirconia crown used for restoring pulpotomized primary molars, on their Fracture Resistance and to compare the loads to failure these different ceramic restorations with previously reported posterior occlusal forces. METHODS: Twenty mandibular left second primary molars were randomly distributed into two groups (n = 10 in each group) the zirconia Crown (Nusmile zr.) Group (G1) and the lithium disilicate (IPS e.max Press) Endocrown Group (G2). In all groups pulpotomy procedure was done before preparation then each sample was prepared based on their allocated restoration, both zirconia crown (Nusmile zr.) and endocrown (IPS e.max Press) were cemented by dual-cure resin cement. All samples were loaded to failure using a universal testing machine (Instron, USA), and the compressive force was applied. The data were analysed using one-way (ANOVA) and Tukey's post hoc significance difference tests. Differences were considered significant at (p< 0.05). RESULTS: Group zirconia crown (G1) showed significantly higher fracture strength than Group (G2) lithium disilicate endocrown (p < 0.05). CONCLUSION: The zirconia crown showed higher fracture resistance than lithium disilicate endocrown. However, both tested zirconia crown and lithium disilicate endocrown withstood the application of axial occlusal forces greater than the reference values for posterior occlusal loads.

Nigella sativa oil as a pulp medicament for pulpotomized teeth: a histopathological evaluation.

PURPOSE: Concerns about the safety of formocresol (FC) as a pulpotomy agent in Pediatric Dentistry have lead to the search of new capping medicaments. Indigenous plant medicines such as Nigella Sativa (NS) have been the focus of many researches. Therefore the purpose of this study was to investigate histo-pathologically the pulp response to NS oil and FC in dogs. METHOD: Forty teeth in 4 male dogs of undefined breed aging 12-14 months were used in this study. Coronal access cavities were performed on the upper and lower premolars so that both medicaments were tested in the same animal in alternate sides of the mouth. Four weeks after treatment the animals were sacrificed, paraffin sections were prepared for histological, histochemical and immuno-histochemical staining. RESULTS: Specimens in the NS group showed mild to moderate vasodilatation. Few specimens showed scattered inflammatory cell infiltration and the odontoblastic layer was continuous. While the FC group showed moderate to severe vasodilatation with high inflammatory cell infiltrate and degenerative changes. CONCLUSIONS: NS possesses an anti-inflammatory effect and the pulp maintains its vitality after its application, which could qualify its use as a pulp medicament for pulpotomized teeth in clinical practice.

Glucosyltransferase B, immunoglobulin a, and caries experience among a group of Egyptian preschool children.

PURPOSE: Glucosyltransferase B enzyme (GtfB) plays an essential role in the pathogenesis of dental caries. It catalyzes the synthesis of water-insoluble glucan from sucrose, which is essential for accumulation of Streptococcus mutans in the dental biofilm. On the other hand, salivary immunoglobulin A (sIgA) plays a protective role in the same process. Therefore, the purpose of this study was to attempt to correlate glucosyltransferase B enzyme and immunoglobulin A levels in whole saliva with caries experience in preschool children. METHODS: Forty-five 3- to 6-year-old were examined clinically, and their caries experiences were recorded as decayed, missing, and filled teeth (dmft) scores. Unstimulated whole saliva was collected and analyzed for GtfB and IgA using enzyme-linked immunosorbent assay. RESULTS: Mixed-model analysis revealed that both GtfB and IgA are covariants regarding the effect on dmft scores (P =.008). GtfB levels displayed a simultaneous increase in caries experience (dmft) and number of carious lesions (d), while IgA levels were high in caries-free children and significantly lower values were obtained in the high caries group. CONCLUSION: Salivary IgA was negatively correlated with caries experience and inversely proportional with GtfB levels in the saliva of preschool children.